The Financial Administrative Specialist is part of the Central Consolidated Patient Accounts Center (CCPAC) in Leavenworth, KS. The CCPAC is a regionally consolidated business entity established to enhance revenue operations throughout the VHA network with the standardization and consolidation of functions and the integration of VHA and industry best practices.

Duties

As a Financial Administrative Specialist, the incumbent will perform a wide range of functions involving the review, analysis and evaluation of billing and collection activity information. The incumbent will have comprehensive knowledge of a broad range of laws, policies, regulations, and precedents applicable to the administration of one or more important public programs related to health care financial management such as PL 99-272, Veterans Healthcare Amendment of 1986; Omnibus Reconciliation Act of 1990; PL 104-262, Veteran's Healthcare Eligibility Reform Act of 1996; Veterans' Millennium Healthcare Act, ICD-9, CPT, HCPCS (Health Care Financing Common Procedural Coding System), FOIA, HIPPA, etc. as well as working knowledge of the framework of regulatory material regarding healthcare billing such as Medicare, TRICARE, and CHAMPVA; familiarity with the IC0-9, CPT and HCPCS coding systems; and the oral and written communication skills necessary to establish and maintain effective work relationships with a broad range of people and be able to concisely present financial information and data to management, staff and Veterans. The incumbent's duties include, but are not limited to: Monitoring claims transmissions from the CPAC to payers. Identifying trends, patterns, deviations, errors, and other activity to develop remedial action(s) and institutionalize higher claims productivity. Reviewing and evaluating system error reports from payers and other sources. Maintaining a log of error reports, sources, corrective action taken and timelines. Establishing deadlines for error correction and ensuring that corrective action is executed within established policies and schedules. Developing and presenting reports of patterns and trends by carrier, organization, provider, etc. to provide constructive feedback for improvement to the appropriate source. Maintaining control of and reporting on software 'patch' implementation; ensuring that all patches are implemented in accordance with established policies, procedures, and deadlines. Functioning as liaison with IRM, 01 and/or contractors for the receipt, implementation, and troubleshooting of software patches and actively participating in new system implementation, and training. Aiding as needed to the Billing and/or Collections staff on system operation, enhancements, and repair to minimize downtime. Creating and maintaining database files needed to monitor and report on a wide range of system related activities. Maintaining accurate claims data to ensure that systematic and ad-hoc reports reflect correct and timely information concerning days-to-bill, amount billed, CPT Codes, etc. and preparing recurring and ad-hoc management reports on Billing and Collection activities. Periodically reviewing claims for healthcare services, equipment and/or medication in accordance with prevailing guidelines. Reviewing claims through random or structured sampling. Claims are submitted for payment within the timeframes established by industry standard(s) and/or VHA requirement using the appropriate claim form, e.g., HCFA-1450, 1500, UB, Sharing Agreement, etc. Reviewing billing information entered and maintained in the automated billing system is timely and accurate. Preparing correspondence, reports, memoranda, or other written products concerning a wide range of issues surrounding billing and/or collection activities. Providing information and assistance to other healthcare team members to improve the documentation, efficiency, and effectiveness of billing operations. Work Schedule: Monday - Friday 8:00AM - 4:30PM Telework: Eligible 6+ days/pay period after training is concluded Position Description/PD#: Financial Administrative Specialist/PD34149A Relocation/Recruitment Incentives: Not Authorized Critical Skills Incentive (CSI): Not Authorized Permanent Change of Station (PCS): Not Authorized Financial Disclosure: Not Required

Requirements

Qualifications

To qualify for this position, applicants must meet all requirements by the closing date of this announcement, 12/26/2024. TIME-IN-GRADE REQUIREMENT: Applicants who are current Federal employees and have held a GS grade any time in the past 52 weeks must also meet time-in-grade requirements by the closing date of this announcement. For a GS-9 grade position you must have served 52 weeks at the GS-7 grade. The grade may have been in any occupation, but must have been held in the Federal service. An SF-50 that shows your Time-In-Grade eligibility must be submitted with your application. If the most recent SF-50 has an effective date within the past year, it may not clearly demonstrate that you possess one-year of Time-In-Grade, as required by this job announcement. In that instance, you must provide an additional SF-50 that clearly demonstrates the one-year Time-In-Grade requirement has been met. Time-In-Grade requirements also apply to former Federal employees applying for reinstatement as well as current employees applying for Veterans Employment Opportunities Act of 1998 (VEOA) appointment. You may qualify based on your experience and/or education as described below: Specialized Experience: You must have one year of specialized experience equivalent to at least the next lower grade GS-7 in a normal line of progression for the occupation in the organization. Examples of specialized experience would typically include, but are not limited to: Developing and presenting reports of trends, patterns, deviations, and errors. Creating and maintaining database files to monitor and report on wide range of system related activities. Preparing correspondence, reports, memorandum or other written products concerning a wide range of issues surrounding billing and/or collection activities. OR Education: Applicants may substitute education for the required experience. To qualify based on education for this grade level you must have: Master's degree or equivalent graduate degree; or 2 full years of progressively higher-level graduate education leading to such a degree or LL.B.; or J.D., if related, from an accredited college or university. Such education must demonstrate the knowledge, skills, and abilities necessary to do the work of this position. [ transcripts required ] OR Combination: Applicants may also combine education and experience to qualify at this level. You must have an equal combination of specialized experience and education beyond graduate level from an accredited college or university directly related to the work of this position. [ transcripts required ] You will be rated on the following Competencies for this position: Organizational Performance Analysis Technical Competence Database Administration Communications Physical Requirements: there are no unusual physical requirements for this position. Experience refers to paid and unpaid experience, including volunteer work done through National Service programs (e.g., Peace Corps, AmeriCorps) and other organizations (e.g., professional; philanthropic; religions; spiritual; community; student; social). Volunteer work helps build critical competencies, knowledge, and skills and can provide valuable training and experience that translates directly to paid employment. You will receive credit for all qualifying experience, including volunteer experience. A full year of work is considered to be 35-40 hours of work per week. Part-time experience will be credited on the basis of time actually spent in appropriate activities. Applicants wishing to receive credit for such experience must indicate clearly the nature of their duties and responsibilities in each position and the number of hours a week spent in such employment. For more information on these qualification standards, please visit the OPM website.

Education

Transcripts must be submitted with your application if you are basing any part of your qualifications on education.

Only education or degrees recognized by the U.S. Department of Education from accredited colleges, universities, schools, or institutions may be used to qualify for Federal employment. You can verify your educational accreditation status here.

If you are using foreign education to meet qualification requirements, you must send a Certificate of Foreign Equivalency with your transcript in order to receive credit for that education. For additional information, please review this link.

Contacts

• Address Central Consolidated Patient Accounts Center 3819 Franklin Ave Building 19 Leavenworth, KS 66048 US
• Name: VHA National Recruitment Center
• Phone: (844)456-5208
• Email: [email protected]